Drugs and fertility is a complicated subject as there are a lot of drugs that have a direct impact on fertility (and some of them are widely used in assisted reproduction like IVF!), but most of the research on other drugs and fertility has focused on male fertility, simply because it’s much easier to see the effect of drugs on sperm than on eggs as they’re a lot easier to get hold of, there’s a lot more of them, and they’re constantly being made, so real changes to drug exposure can been seen in relatively short time frames. There’s also the issue that semen testing doesn’t reduce fertility, which happens if eggs are taken from the ovaries.
Some drugs are known to interfere with sperm development and reduce the number of healthy sperm in semen samples, and certain drugs also affect a man’s sex drive and/or his ability to maintain an erection. It’s highly possible these drugs have similar affects on follicle development, but the relative lack of research on how drugs affect female fertility means it’s not clear. However we do have information on how some widely used drugs affect breastfeeding mothers and their babies, along with suggestions of therapeutic alternatives to them.
Non-prescription drugs and fertility
Because there’s strong evidence many 26-50 year old men use illegal drugs, they’re an important issue for many couples trying for a baby; and an estimate of illegal drug use by U.S.A men is:i
|Age of men||Used a drug in the last year||Used a drug in the past month|
Clinical trials on illegal drugs aren’t straightforward (simply because of the ethics involved), but the effects that are known are:
|Drug||Impact on men||Impact on women|
|Marijuana||Affects the testes and sperm development, leading to lower hormone levels (LH and testosterone), lower sperm functionality, morphology and motility in menii||Disrupts the menstrual cycles, which reduces the development of follicles and reduces embryo implantation rates and developmentiii|
|Opiates (including prescription)||Reduce testosterone production, libido and erectile function|
|Cocaine||Impairs erectile function and may reduce sperm concentration||The children of women who take cocaine during the pregnancy are more likely to develop abnormally|
|Anabolic steroids||Abnormal sperm, no sperm, atrophy of the testes, hypogonadism, and it can take a year or more to recover fertility|
Prescription drugs and fertility
Again there’s more information on how prescription drugs affect men rather than women.
Table III shows the known effects of many medications:iv
|Medication||Effect of reproduction||Length of effect|
|Antibiotics: Ampicillin, cephalotin, cotrimoxazole, gentamycin, neomycin, nitrofurantoin, Penicillin G, spiramycin||Impairs the development of sperm||Reversible|
|Anti-Epiletics: Phenytoin||Impairs sperm motility||Reversible|
|Antihypertensives: Alpha agonists (clonidine), alpha blockers (prazocin), beta blockers,hydralazine, methyldopa, thiazide diuretics
Calcium channel blockers (nifedipine)
|Anti-inflammatories: Mesalazine, sulfasalazine||Impairs the development of sperm and sperm motility||Reversible|
|Antimalarials: Quinine and its derivatives||Impairs sperm motility||Reversible|
|Antidepressants/ Antipsychotics: Alpha blockers, phenothiazine, (particularly SSRIs)
|Increase prolactin concentrations that can lead to sexual dysfunction and reduced sperm motilityv
Impairs the development of sperm and sperm motility
|Corticosteroids:||Reduces sperm concentration and motility||Reversible|
|Non-steroidal anti-inflammatory drugs (NSAIDS): Cox-2 inhibitors||Impairs the rupturing of the follicle and ovulation, and impairs tubal function||Reversible|
Many people take medicines essential for health, so anyone thinking of stopping taking prescribed medicines should see their MD/GP as unsupervised withdrawal could have serious health consequences.
Ten ‘Over the Counter’ drugs to avoid during pregnancyvi